Insulin resistance and islet β-cell function in patients with gestational diabetes mellitus

Abstract

Objective To study the characteristics of insulin resistance and islet β-cell function in patients with gestational diabetes mellitus, so as to investigate the possible pathogenesis of gestational diabetes mellitus (GDM). Methods From January 2010 to January 2015, 3 008 pregnant women with routine antenatal examination were selected. At the first prenatal examination (gestational age of 20 to 28 weeks), the levels of fasting plasma hematospermia, fasting insulin, total cholesterol (Chol), triglyceride (TG), high density lipoprotein (serum HDL), low density lipoprotein (LDL-C) were detected, and at the same time the 50 g glucose screening test was made, then glucose tolerance test was made for the patients with the results greater than or equal to 7.8 mmol/L. According to OGIT results, the pregnant women were divided into gestational diabetes mellitus(GDM) group(50 cases), gestational impaired glucose tolerance(GIGT) group(50 cases), and normal glucose tolerance(NGT) group(50 cases). The blood glucose curve area (AUCG) and insulin curve area (AUCI), homeostasis model assessment of islet beta cell function indexes, mixed insulin sensitivity, homeostasis model assessment of insulin resistance indexes and insulin secretion indexes were compared. Results In GDM group, the levels of FINS, blood glucose, C peptide, HOMA-IR, PGAUC and other indicators at each time point were significantly higher than those in normal control group, and the differences were significant (P 0.05). Conclusions Insulin resistance in patients with GDM is higher than that of normal women in pregnancy, and the function of pancreatic secretion is impaired at the same time, and there is no significant difference in insulin resistance between GIGT group and normal pregnant women. The reason of abnormal glucose metabolism in pregnancy is more supportive of insulin resistance, but not the secretion of islet β-cell. Key words: Diabetes mellitus; Pregnancy; Insulin resistance; Islet β-cell function